An IAEA survey of radiotherapy practice including quality assurance extent and depth

Healy, Brendan; Budanec, Mirjana; Ourdane, B; Peace, T; Petrović, Borislava; Sanz, Dolores; Scanderbeg, Daniel J.; Tuntipumiamorn, Lalida

doi:10.1080/0284186x.2020.1714721

Cited by 10 publications

(9 citation statements)

References 5 publications

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“…From this study, there were on average 1.2 medical physicists per treatment unit in Taiwan, this level is lower than the worldwide average, although the treatment resource in Taiwan is much higher than the worldwide average. This survey re ects that radiation oncology medical physicists in Taiwan generally are overworked, just like the reports from IAEA worldwide survey and the Asia Paci c region survey [18,19].…”

Section: Treatment Resource and Medical Physicist Sta Ngmentioning

confidence: 93%

“…The treatment resource in Taiwan is about 7.5 MV/MeV/ion beam therapy machines per million population, which is roughly similar to Australia and France [17,18]. According to the IAEA radiotherapy practice survey [19], the sta ng levels for those departments without dosimetrists there were on average 1.3 medical physicists per treatment unit, and this level is at the low end range compared with IAEA recommendations [20]. From this study, there were on average 1.2 medical physicists per treatment unit in Taiwan, this level is lower than the worldwide average, although the treatment resource in Taiwan is much higher than the worldwide average.…”

Section: Treatment Resource and Medical Physicist Sta Ngmentioning

confidence: 99%

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Radiotherapy Dosimetry Audits in Taiwan Hospitals

Shiau¹,

Hsu²,

Huang³

et al. 2020

Preprint

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Purpose: This study examines the practice of the regulation of Standards for Medical Exposure Quality Assurance (SMEQA) in Taiwan based on on-site quality audit for radiation therapy systems from 2016 to 2019. Methods and Materials: about 81 radiation therapy departments, 141 medical linear accelerators, 9 gamma knifes, 34 high dose rate brachytherapy systems, 20 Tomotherapys and 6 Cyberknives were audited yearly. The inspection was implemented in two stages. Data collection and analysis for each institute’s documents including QA operating procedure, ion chamber and electrometer calibration reports, and a questionnaire relating to machine type and staffing, were requested first and reviewed by specially trained auditors. On-site measurements of SMEQA core items, including beam output, beam profile and energy constancy for external beam therapy systems, and the source strength, positioning and timer accuracy for brachytherapy systems were audited second. More than 300 photon beams were measured from linacs, Gamma knives, Cyberknives and Tomotherapys, and more than 400 electron beams from linacs each year.Results: The radiation treatment resource is about 8.9 therapy machines or 7.5 MV/MeV/ion beam therapy machines per million population, respectively, and there are on average about 1.20 medical physicists per radiation therapy unit in Taiwan. There were more than 78% and 75% of photon and electron beams respectively from linacs with deviations measured to the stated reference-point dose within 1.0%. Photon beams have lower beam quality measurement deviations than electron beams, and more than 90% of photon beams from linacs were within 1.0%. Including in-plane and cross-plane measurements, more than 90% and 85% of photon and electron beams respectively with flatness consistency within 1.0%. Beam symmetry as an absolute value has more than 75% of measurements within 1.0%. All audit measurements in this study were within the SMEQA acceptance criteria.Conclusions: On-site machine QA audits have been implemented from 2016 to 2019 for all radiation therapy units each year. The measurement results have shown a high quality machine performance in Taiwan.

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Section: Treatment Resource and Medical Physicist Sta Ngmentioning

confidence: 93%

Section: Treatment Resource and Medical Physicist Sta Ngmentioning

confidence: 99%

Radiotherapy Dosimetry Audits in Taiwan Hospitals

Shiau¹,

Hsu²,

Huang³

et al. 2020

Preprint

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“…In low‐income countries, however, cervical cancer patients receive radiotherapy after long waiting period largely because of shortage of radiotherapy facilities 4 . For example, at the time of our study, there was only one functional radiotherapy machine for 110 million people in Ethiopia, compared to one radiotherapy machine for about 20 000 people in the United States 5 …”

Section: Introductionmentioning

confidence: 90%

“…4 For example, at the time of our study, there was only one functional radiotherapy machine for 110 million people in Ethiopia, compared to one radiotherapy machine for about 20 000 people in the United States. 5 Several previous studies associated shortage of radiotherapy machines with longer waiting period for receipt of cancer treatments and poorer survival. 6,7 Only two studies, however, examined the association between delay in receipt of radiotherapy and disease progression to higher stages.…”

Section: Introductionmentioning

confidence: 99%

Association between waiting time for radiotherapy initiation and disease progression among women with cervical cancer in Addis Ababa, Ethiopia

Dereje

Addissie

Worku

et al. 2021

Intl Journal of Cancer

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There is shortage of radiotherapy machines in low-income countries, including Ethiopia.Data on adverse effects of this on cancer outcomes are limited, however. Herein, we examined the extent of waiting time for radiotherapy and its association with disease progression based on a prospective cohort study of women diagnosed with stage IA-IVA cervical cancer in Addis Ababa and who were scheduled to receive radiotherapy at Tikur Anbessa Specialized Hospital, the only hospital that provides radiotherapy services in the country. Association was examined using Multivariable mixed effects logistic regression model. Among the 178 women with cervical cancer scheduled for receipt of radiotherapy and with vital status information, 16 deceased (9.0%) while waiting for radiotherapy. For the remaining 162 women who initiated radiotherapy, the median treatment waiting period was 137 days (IQR = 60-234 days), with 74.1% of women waiting for >60 days. Tumor progressed to higher stage for 44.4% of these women.Compared to those women who initiated radiotherapy ≤60 days after diagnostic confirmation, the odds of tumor progression to higher stage was three times higher in those women who initiated radiotherapy between 120-179 days (aOR =3.30, 95%CI: 1.18-9.27) and ≥180 days (aOR =3.06, 95%CI: 1.24-7.52). Waiting period for receipt of radiotherapy among women with cervical cancer is exceedingly long in Addis Ababa, and it is associated with disease progression to higher stages. These findings reinforce the need to expand radiotherapy infrastructure in order to mitigate the undue high burden of the disease in Ethiopia and other parts of Africa.

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“…Tables of the levels of accuracy that are practically achievable in each of the different steps in the radiotherapy process, were provided. The article by Healy et al [3] in this volume provides a snapshot of the extent and depth of quality assurance and quality control activities being performed in radiotherapy clinics across the world that participated in a coordinated research project.…”

mentioning

confidence: 99%